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Teo SM, Segurado R, Mehegan J, Douglass A, Murrin CM, Cronin M, Kelleher CC, McAuliffe FM, Phillips CM. Sociodemographic factor associations with maternal and placental outcomes: A cluster and partial least squares regression analysis. Placenta 2024; 150:62-71. [PMID: 38593637 DOI: 10.1016/j.placenta.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/19/2024] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Maternal social disadvantage adversely affects maternal and offspring health, with limited research on placental outcomes. Therefore, we examined maternal sociodemographic factor associations with placental and birth outcomes in general (Lifeways Cross-Generation Cohort) and at-risk (PEARS Study of mothers with overweight or obesity) populations of pregnant women. METHODS TwoStep cluster analysis profiled Lifeways mothers (n = 250) based on their age, parity, marital status, household income, private healthcare insurance, homeowner status, and education. Differences in placental and birth outcomes (untrimmed placental weight (PW), birthweight (BW) and BW:PW ratio) between clusters were assessed using one-way ANOVA and chi-square tests. Partial least squares regression analysed individual effects of sociodemographic factors on placental and birth outcomes in Lifeways and PEARS mothers (n = 461). RESULTS Clusters were classified as "Married Homeowners" (n = 140, 56 %), "Highest Income" (n = 58, 23.2 %) and "Renters" (n = 52, 20.8 %) in the Lifeways Cohort. Renters were younger, more likely to smoke, have a means-tested medical card and more pro-inflammatory diets compared to other clusters (p < 0.01). Compared to Married Homeowners, renters' offspring had lower BW (-259.26 g, p < 0.01), shorter birth length (-1.31 cm, p < 0.01) and smaller head circumference (-0.59 cm, p = 0.02). PLS regression analyses identified nulliparity as having the greatest negative effect on PW (Lifeways and PEARS) while being a homeowner had the greatest positive effect on PW (Lifeways). CONCLUSION Certain combinations of sociodemographic factors (particularly homeownership) were associated with less favourable lifestyle factors, and with birth, but not placental outcomes. When explored individually, parity contributed to the prediction of placental and birth outcomes in both cohorts of pregnant women.
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Affiliation(s)
- Shevaun M Teo
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland.
| | - Ricardo Segurado
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland.
| | - John Mehegan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland.
| | - Alexander Douglass
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland.
| | - Celine M Murrin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland.
| | - Martina Cronin
- National Maternity Hospital, Holles Street, Dublin, Ireland.
| | - Cecily C Kelleher
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland.
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland.
| | - Catherine M Phillips
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland.
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Mattson A, Doherty K, Lyons A, Douglass A, Kerley M, Stynes S, Fitzpatrick P, Kelleher C. Evidence from a Smoking Management Service in a University Teaching Hospital in Dublin, Ireland monitored by repeat surveys, 1997-2022. Prev Med Rep 2023; 36:102415. [PMID: 37744740 PMCID: PMC10511793 DOI: 10.1016/j.pmedr.2023.102415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 05/11/2023] [Accepted: 09/11/2023] [Indexed: 09/26/2023] Open
Abstract
St Vincent's University Hospital (SVUH) has a comprehensive smoking management programme and since 1997 has conducted periodic surveys of inpatients, outpatients, staff and visitors to establish prevalence of smoking and associated attitudes towards the hospital's smoke-free campus policy pioneered in 2009. We report trends and describe also the online community stop smoking course (SSC) developed more recently in response to COVID-19. A questionnaire examining attitudes and smoking status was administered by census surveys of inpatients, quota or random sub-sample surveys of staff, and quota surveys with outpatients and visitors in the time period of 1997-2018. Chi square test for trend was used. Smoking rates declined in all groups but significantly so in outpatients (19.5% vs. 10%; p < 0.01), visitors (27.4% vs. 9.5%; p < 0.0001) and staff (30.0% vs. 10.8%; p < 0.0001). Use of E-Cigarettes was low in all cohorts. Rates of smoking were borderline higher in inpatients eligible by income for state-funded General Medical Services (33.2% vs 26.8%, p = 0.099). Support for and awareness of the ban increased over time. Demographic and quit data was compared between participants of in-person or online SSC. The online courses were successful with a maintenance of quit rates (End of Course: 54.7% vs. 55.0%, 1 Month: 50.4% vs. 54.0%, 3 Month: 19.8% vs. 22.5%). While the hospital community's smoking prevalence has decreased over time and attitudes to the smoking ban have been increasingly positive, the campus is not without difficulties in keeping it smoke-free. We continue to advocate for hospital staff support in enacting this flagship initiative.
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Affiliation(s)
- Ana Mattson
- Department of Preventive Medicine & Health Promotion, Saint Vincent’s University Hospital, Elm Park, Dublin, Ireland
| | - Kirsten Doherty
- Department of Preventive Medicine & Health Promotion, Saint Vincent’s University Hospital, Elm Park, Dublin, Ireland
| | - Ailsa Lyons
- Department of Preventive Medicine & Health Promotion, Saint Vincent’s University Hospital, Elm Park, Dublin, Ireland
| | - Alexander Douglass
- UCD School of Public Health, Physiotherapy and Sports Science, Belfield, Dublin, Ireland
| | - Mary Kerley
- Department of Preventive Medicine & Health Promotion, Saint Vincent’s University Hospital, Elm Park, Dublin, Ireland
| | - Sinead Stynes
- Department of Preventive Medicine & Health Promotion, Saint Vincent’s University Hospital, Elm Park, Dublin, Ireland
| | - Patricia Fitzpatrick
- Department of Preventive Medicine & Health Promotion, Saint Vincent’s University Hospital, Elm Park, Dublin, Ireland
- UCD School of Public Health, Physiotherapy and Sports Science, Belfield, Dublin, Ireland
| | - Cecily Kelleher
- Department of Preventive Medicine & Health Promotion, Saint Vincent’s University Hospital, Elm Park, Dublin, Ireland
- UCD School of Public Health, Physiotherapy and Sports Science, Belfield, Dublin, Ireland
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Teo SM, Murrin CM, Mehegan J, Douglass A, Hébert JR, Segurado R, Kelleher CC, Phillips CM. Associations between the maternal healthy lifestyle score and its individual components during early pregnancy with placental outcomes. Placenta 2023; 139:75-84. [PMID: 37336158 DOI: 10.1016/j.placenta.2023.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/29/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023]
Abstract
INTRODUCTION The influence of maternal lifestyle behaviours on placental growth have been investigated individually, but with conflicting results, and their combined effect is under-researched. Therefore, we examined associations between a composite maternal healthy lifestyle score (HLS), and its individual components, during early pregnancy with placental outcomes. METHODS Participants included Lifeways Cross-Generational Cohort mother-child pairs (n = 202). A composite HLS based on a less inflammatory diet (bottom 40% of the energy-adjusted Dietary Inflammatory Index (E-DII™)), moderate-to-vigorous physical activity (MVPA), healthy pre-pregnancy BMI (18.5-24.9 kg/m2), never smoking, and non-/moderate alcohol intake was calculated. Quantile regression analysed HLS (and individual components) associations with measures of placental development (untrimmed placental weight (PW)) and function (birth weight:placental weight (BW:PW) ratio) at the 10th, 25th, 50th, 75th and 90th centiles. RESULTS A more pro-inflammatory diet was positively, and smoking and heavy alcohol consumption were negatively, associated with PW at median centiles (B: 41.97 g, CI: 3.71, 80.22, p < 0.05; B: -58.51 g, CI: -116.24, -0.77, p < 0.05; B: -120.20 g, CI: -177.97, -62.43, p < 0.05 respectively). Low MVPA was inversely associated with BW:PW ratio at the 10th and 90th centiles (B: -0.36, CI: -0.132, -0.29, p < 0.01 and B: -0.45, CI: -0.728, -0.182, p < 0.01, respectively). Heavy alcohol intake was positively associated with BW:PW ratio at the 10th centile (B: 0.54, CI: 0.24, 0.85, p < 0.01). Results of sex-stratified analysis provide evidence of sexual dimorphism. DISCUSSION Associations of certain lifestyle factors, but not the composite HLS, during early pregnancy with measures of placental development (PW) and function (BW:PW ratio) varied by quantiles and by sex.
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Affiliation(s)
- Shevaun M Teo
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, 4, Ireland.
| | - Celine M Murrin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, 4, Ireland.
| | - John Mehegan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, 4, Ireland.
| | - Alexander Douglass
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, 4, Ireland.
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
| | - Ricardo Segurado
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, 4, Ireland.
| | - Cecily C Kelleher
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, 4, Ireland.
| | - Catherine M Phillips
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, 4, Ireland.
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Lecorguillé M, Schipper MC, O'Donnell A, Aubert AM, Tafflet M, Gassama M, Douglass A, Hébert JR, de Lauzon-Guillain B, Kelleher C, Charles MA, Phillips CM, Gaillard R, Lioret S, Heude B. Impact of parental lifestyle patterns in the preconception and pregnancy periods on childhood obesity. Front Nutr 2023; 10:1166981. [PMID: 37275643 PMCID: PMC10233059 DOI: 10.3389/fnut.2023.1166981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/07/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction High prevalence of overweight and obesity already observed in preschool children suggests the involvement of early-life risk factors. Preconception period and pregnancy are crucial windows for the implementation of child obesity prevention interventions with parental lifestyle factors as relevant targets. So far, most studies have evaluated their role separately, with only a few having investigated their potential synergistic effect on childhood obesity. Our objective was to investigate parental lifestyle patterns in the preconception and pregnancy periods and their association with the risk of child overweight after 5 years. Materials and methods We harmonized and interpreted results from four European mother-offspring cohorts participating in the EndObesity Consortium [EDEN, France; Elfe, France; Lifeways, Ireland; and Generation R, Netherlands] with data available for 1,900, 18,000, 1,100, and 9,500 families, respectively. Lifestyle factors were collected using questionnaires and included parental smoking, body mass index (BMI), gestational weight gain, diet, physical activity, and sedentary behavior. We applied principal component analyses to identify parental lifestyle patterns in preconception and pregnancy. Their association with risk of overweight (including obesity; OW-OB) and BMI z-scores between 5 and 12 years were assessed using cohort-specific multivariable logistic and linear and regression models (adjusted for potential confounders including parental age, education level, employment status, geographic origin, parity, and household income). Results Among the various lifestyle patterns derived in all cohorts, the two explaining the most variance were characterized by (1) "high parental smoking, low maternal diet quality (and high maternal sedentary behavior in some cohorts)" and, (2) "high parental BMI and low gestational weight gain." Patterns characterized by high parental BMI, smoking, low diet quality or high sedentary lifestyle before or during pregnancy were associated with higher risk of OW-OB in children, and BMI z-score at any age, with consistent strengths of associations in the main cohorts, except for lifeways. Conclusion This project provides insight into how combined parental lifestyle factors in the preconception and pregnancy periods are associated with the future risk of child obesity. These findings are valuable to inform family-based and multi-behavioural child obesity prevention strategies in early life.
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Affiliation(s)
- Marion Lecorguillé
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Mireille C Schipper
- The Generation R Study Group (Na 29-15), Erasmus University Medical Center, CA, Rotterdam, Netherlands
| | - Aisling O'Donnell
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Adrien M Aubert
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Muriel Tafflet
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | | | - Alexander Douglass
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- Department of Nutrition, Connecting Health Innovations, LLC, Columbia, SC, United States
| | - Blandine de Lauzon-Guillain
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Cecily Kelleher
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Marie-Aline Charles
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
- Ined, Inserm, EFS, Joint Unit Elfe, Aubervilliers, France
| | - Catherine M Phillips
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Romy Gaillard
- The Generation R Study Group (Na 29-15), Erasmus University Medical Center, CA, Rotterdam, Netherlands
| | - Sandrine Lioret
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
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Lecorguillé M, Schipper M, O'Donnell A, Aubert AM, Tafflet M, Gassama M, Douglass A, Hébert JR, Kelleher C, Charles MA, Phillips CM, Gaillard R, Lioret S, Heude B. Parental lifestyle patterns around pregnancy and risk of childhood obesity in four European birth cohort studies. Lancet Glob Health 2023; 11 Suppl 1:S5. [PMID: 36866482 DOI: 10.1016/s2214-109x(23)00090-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
BACKGROUND A high prevalence of excess weight in children younger than 5 years suggests the involvement of early-life risk factors. The preconception and pregnancy periods are crucial stages for the implementation of interventions to prevent childhood obesity. Most studies so far have evaluated the effects of early-life factors separately, with only a few investigating the combined effect of parental lifestyle factors. Our objective was to fill the literature gap regarding parental lifestyle factors in the preconception and pregnancy periods and to study their association with the risk of overweight in children after the age of 5 years. METHODS We harmonised and interpreted data from four European mother-offspring cohorts (EDEN [comprising 1900 families], Elfe [comprising 18 000 families], Lifeways [comprising 1100 families], and Generation R [comprising 9500 families]). Written informed consent was obtained from parents of all involved children. Lifestyle factor data collected through questionnaires comprised parental smoking, BMI, gestational weight gain, diet, physical activity, and sedentary behaviour. We applied principal component analyses to identify multiple lifestyle patterns in preconception and pregnancy. Their association with child BMI z-score and risk of overweight (including obesity, overweight and obesity, as defined by the International Task Force reference) between the ages of 5 and 12 years were assessed using cohort-specific multivariable linear and logistic regression models (adjusted for confounders including parental age, education level, employment status, geographic origin, parity, and household income). FINDINGS Among the various lifestyle patterns identified in all cohorts, the two that better explained variance were high parental smoking plus low maternal diet quality or high maternal sedentary behaviour, and high parental BMI plus low gestational weight gain. Overall, we observed that patterns characterised by high parental BMI, smoking, low-quality diet, or sedentary lifestyle before or during pregnancy were associated with higher BMI z-scores and risk of overweight and obesity in children aged 5-12 years. INTERPRETATION Our data contribute to a better understanding of how parental lifestyle factors might be associated with the risk of childhood obesity. These findings are valuable to inform future family-based and multi-behavioural child obesity prevention strategies in early life. FUNDING European Union's Horizon 2020 under the ERA-NET Cofund action (reference 727565) and European Joint Programming Initiative "A Healthy Diet for a Healthy Life" (JPI HDHL, EndObesity).
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Affiliation(s)
- Marion Lecorguillé
- Center for Research in Epidemiology and Statistics, National Institute of Health and Medical Research and National Research Institute for Agriculture, Food and the Environment, Université Paris Cité and Université Sorbonne Paris Nord, Paris, France.
| | - Mireille Schipper
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Aisling O'Donnell
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Adrien M Aubert
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Muriel Tafflet
- Center for Research in Epidemiology and Statistics, National Institute of Health and Medical Research and National Research Institute for Agriculture, Food and the Environment, Université Paris Cité and Université Sorbonne Paris Nord, Paris, France
| | - Malamine Gassama
- UMS Elfe Team, French Institute for Demographic Studies, National Institute of Health and Medical Research, French Blood Agency, Aubervilliers, France
| | - Alexander Douglass
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Connecting Health Innovations, Columbia, SC, USA
| | - Cecily Kelleher
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Marie-Aline Charles
- Center for Research in Epidemiology and Statistics, National Institute of Health and Medical Research and National Research Institute for Agriculture, Food and the Environment, Université Paris Cité and Université Sorbonne Paris Nord, Paris, France; UMS Elfe Team, French Institute for Demographic Studies, National Institute of Health and Medical Research, French Blood Agency, Aubervilliers, France
| | - Catherine M Phillips
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Romy Gaillard
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Sandrine Lioret
- Center for Research in Epidemiology and Statistics, National Institute of Health and Medical Research and National Research Institute for Agriculture, Food and the Environment, Université Paris Cité and Université Sorbonne Paris Nord, Paris, France
| | - Barbara Heude
- Center for Research in Epidemiology and Statistics, National Institute of Health and Medical Research and National Research Institute for Agriculture, Food and the Environment, Université Paris Cité and Université Sorbonne Paris Nord, Paris, France
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McFarland L, Macken-Walsh Á, Claydon G, Casey M, Douglass A, McGrath G, McAloon CG. Irish dairy farmers' engagement with animal health surveillance services: Factors influencing sample submission. J Dairy Sci 2020; 103:10614-10627. [PMID: 32861485 DOI: 10.3168/jds.2019-17889] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 05/25/2020] [Indexed: 11/19/2022]
Abstract
A high-quality animal health surveillance service is required to inform policy and decision-making in food-animal disease control, to substantiate claims regarding national animal health status and for the early detection of exotic or emerging diseases. In Ireland, the Department of Agriculture, Food and the Marine provides partially subsidized testing of farm animal samples and postmortem examinations to the Irish agriculture sector (farmers) at 6 regional veterinary laboratories (RVL) throughout the country. Diagnoses and data from these submissions are recorded and reported monthly and annually to enable animal health monitoring and disease surveillance. In a passive surveillance model, both the veterinary practitioner and the farmer play a vital role in sample submission by determining which cases are sent to the laboratory for postmortem or diagnostic testing. This paper identified factors influencing Irish dairy farmers' decisions to submit carcasses to RVL. Behavioral determinants of the submission of samples where veterinary professionals are concerned has been studied previously; however, limited work has studied determinants among farmers. This study conducted qualitative analyses of decisions of Irish dairy farmers relevant to diagnostic sample submission to an RVL and to examine the herd-level characteristics of farmers that submitted cases to an RVL. The biographical narrative interpretive method was used to interview 5 case-study farmers who were classified nonsubmitters, medium, or high submitters to the postmortem service based on the proportion of on-farm mortalities submitted to the laboratory service in 2016. The data obtained from these interviews were supplemented and triangulated through dairy farmer focus groups. The data were thematically analyzed and described qualitatively. In addition, quantitative analysis was undertaken. Data for herds within the catchment area of a central RVL were extracted, and a multivariable logistic regression model was constructed to examine the relationship between herds from which carcasses were submitted to the laboratory and those from which none were submitted. Results from the analysis show that the farmer's veterinary practitioner was the primary influence on submission of carcasses to the laboratory. Similarly, the type of incident, logistical issues with transporting carcasses to the laboratory, influence of peers, presence of alternative private laboratories, and a fear of government involvement were key factors emerging from the case-study interview and focus group data. Herd size was identified in both the qualitative and quantitative analysis as a factor determining submission. In the logistic regression model, herd size and increased levels of expansion were positively correlated with the odds of submission, whereas distance from the laboratory was negatively associated with odds of submission. These results identify the main factors influencing the use of diagnostic services for surveillance of animal health, signaling how services may be made more attractive by policy makers to a potentially wider cohort of users.
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Affiliation(s)
- Lauren McFarland
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland D04 W6F6
| | - Áine Macken-Walsh
- Department of Agri-Food Business and Spatial Analysis, Rural Economy Development Programme, Teagasc, Athenry, Ireland H65 R718.
| | - Grace Claydon
- Department of Agri-Food Business and Spatial Analysis, Rural Economy Development Programme, Teagasc, Athenry, Ireland H65 R718
| | - Mícheál Casey
- Regional Veterinary Laboratories Division, Backweston Campus, Department of Agriculture, Food and the Marine, Celbridge, Kildare, Ireland W23 X3PH
| | - Alexander Douglass
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland D04 W6F6
| | - Guy McGrath
- Centre for Veterinary Epidemiology and Risk Analysis, University College Dublin, Belfield, Dublin, Ireland D04 W6F6
| | - Conor G McAloon
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland D04 W6F6
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Saad M, Bujaki B, Douglass A, Lee E, Ray L, De Koninck J, Robillard R. 0969 Antidepressant Use Is Linked to Worse Sleep-Related Breathing Disturbances In People with Depressive Symptoms. Sleep 2018. [DOI: 10.1093/sleep/zsy061.968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Saad
- Faculty of Medicine, University of Ottawa, Ottawa, ON, CANADA
| | - B Bujaki
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, Ottawa, ON, CANADA
| | - A Douglass
- Sleep Clinic, Royal Ottawa Mental Health Centre, Ottawa, ON, CANADA
| | - E Lee
- Sleep Clinic, Royal Ottawa Mental Health Centre, Ottawa, ON, CANADA
| | - L Ray
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, Ottawa, ON, CANADA
| | - J De Koninck
- School of Psychology, University of Ottawa, Ottawa, ON, CANADA
| | - R Robillard
- Sleep Research Unit, The Royal’s Institute of Mental Health Research, Ottawa, ON, CANADA
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BuJáki B, Ray L, Saad M, Lee E, Douglass A, DeKoninck J, Robillard R. 0968 Sleep Architecture and Breathing Disturbances in Comorbid Anxiety and Depression. Sleep 2018. [DOI: 10.1093/sleep/zsy061.967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B BuJáki
- The Royal’s Institute of Mental Health Research, affiliated with University of Ottawa, Ottawa, ON, CANADA
| | - L Ray
- The Royal’s Institute of Mental Health Research, affiliated with University of Ottawa, Ottawa, ON, CANADA
| | - M Saad
- The Royal’s Institute of Mental Health Research, affiliated with University of Ottawa, Ottawa, ON, CANADA
| | - E Lee
- Sleep Clinic, Royal Ottawa Mental Health Centre, Ottawa, ON, CANADA
| | - A Douglass
- Sleep Clinic, Royal Ottawa Mental Health Centre, Ottawa, ON, CANADA
| | - J DeKoninck
- The Royal’s Institute of Mental Health Research, affiliated with University of Ottawa, Ottawa, ON, CANADA
| | - R Robillard
- The Royal’s Institute of Mental Health Research, affiliated with University of Ottawa, Ottawa, ON, CANADA
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Missaghi B, Douglass A, Tolles J, Jordan J. 148 Comparison of Active Learning Techniques: Audience Response Questions vs. Small Group Discussion on Immediate and Long Term Knowledge Gain in Emergency Medicine Sub-Interns and Residents. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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10
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Douglass A, Yip K, Tanen D, Fleischman R, Lumanauw D, Jordan J. 174 Resident Clinical Experience in the Emergency Department: Patient Encounters by Post Graduate Year. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Saad MF, Parvaresh A, Carrier J, Lafrenière A, Bujaki B, Benoit A, Lalande S, Welch K, De Koninck JM, Douglass A, Lee E, Busby K, Robillard R. 1088 HEART RATE SLEEP PROFILE: A NEW BIOMARKER FOR DEPRESSION? Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
BACKGROUND/AIMS To mimic episodic hepatic encephalopathy after gastrointestinal bleeding under controlled conditions, cirrhotic patients were challenged with an amino acid mixture of comparable composition to haemoglobin. METHODS Basal EEG, psychometric score (HE test), reaction times and venous blood ammonia were recorded. Following a 54 or 108 gm oral amino acid challenge, blood ammonia levels and EEG were recorded at 30-min intervals, and psychometric testing was repeated at 180 min. Ten controls (57 +/- 2) and 31 cirrhotics (52 +/- 2) of which 21 were Child's grade A or B and 10 grade C underwent the challenge. Nine had a transjugular intrahepatic porta-systemic shunt in situ. RESULTS Seventeen patients had abnormal baseline HE scores. Basal blood ammonia and reaction time A were significantly greater in patients (52 +/- 5 micromol/l and 478 +/- 20 ms, respectively) than controls (19 +/- 2 micromol/l and 372 +/- 14 ms) (P < 0.001). Following the challenge, in patients with advanced liver disease (Child's grade B and C) the slowing of reaction time A (+85 +/- 38 and +71 +/- 31 ms, respectively; P < 0.03) and EEG (ratio of slow to fast wave activity +0.31 +/- 0.12 and +0.58 +/- 0.19; P < 0.02) were significantly greater than in controls (-3.3 +/- 8 ms and 0.00 +/- 0.03, respectively). Patients with an abnormal basal HE score had the most pronounced changes (reaction time A +110 +/- 39 ms, P < 0.01, EEG +0.52 +/- 13, P < 0.01, respectively). The change in EEG ratio correlated with the dose of amino acid administered (r = 0.96; P < 0.008). CONCLUSION The amino acid challenge constitutes a reproducible human model of episodic, Type C hepatic encephalopathy unaffected by the complications usually encountered in clinical practice.
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Affiliation(s)
- A Douglass
- Department of Medicine, University of Newcastle upon Tyne, UK
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13
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Abstract
OBJECTIVE To determine 1) if the PRIME-MD, a two-step screening and diagnostic instrument for psychiatric disorders, increases diagnosis and intervention when actively implemented in a busy general medicine clinic, and 2) the type of staff support required to achieve sufficient implementation to realize gains in diagnosis and treatment. DESIGN We introduced the PRIME-MD into a large general medicine clinic with repeated rotation of four support conditions for implementation: (1) no support, (2) nonclinical staff support (NCSS), (3) nursing staff (RN) support, and (4) a written "Prompt" condition. SETTING AND PATIENTS Patients (N = 2,263) attending a general medicine clinic at a Veterans Affairs Medical Center. MEASUREMENTS AND MAIN RESULTS Outcome measures were (1) PRIME-MD questionnaire and interview use, (2) overall psychiatric diagnosis, (3) new psychiatric diagnosis, and (4) provider intervention for psychiatric conditions. The NCSS, RN support, and prompt conditions resulted in similar rates of questionnaire use but significantly different rates of structured interview use. The NCSS condition was associated with significant increases in new diagnosis, and the RN support and Prompt condition were associated with significant increases in new diagnosis and intervention compared with no support. CONCLUSIONS Nursing staff support resulted in sufficient PRIME-MD implementation to achieve gains in both new diagnosis and provider intervention compared with no support. These gains occurred in a busy primary care clinic with nonselected providers and customary visit lengths. This level of support should be achievable in most clinical settings.
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Affiliation(s)
- M Valenstein
- Psychiatry Service, SMITREC Health Services Research and Development, Veterans Affairs Medical Center, Ann Arbor, MI 48105, USA
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14
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Douglass A. Rethinking the effects of homelessness on children: resiliency and competency. Child Welfare 1996; 75:741-751. [PMID: 8936486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
An urban family shelter in New England operates an on-site early childhood education program for the children of shelter residents and families living in the community. In contrast to the findings in much of the research on young homeless children, the case examples presented here illustrate the strengths and the coping strategies of homeless children, along with their similarities to their peers in the program who have homes. The importance of understanding the complex and varied experiences children and families have with homelessness is discussed, as well as implications for early childhood teachers, researchers, social workers, and child advocates.
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Affiliation(s)
- A Douglass
- Project Hope Children's Center, Dorchester, MA, USA
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15
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Abstract
Standard methods of ventricular measurement with computed tomography (CT) and magnetic resonance imaging (MRI) allow for as much as a 10-mm variation in the level of the "best" axial slice through the lateral ventricles. In a series of 10 patients who received MRI scans, the effect of 1-mm variations in slice center level on measured ventricle-brain ratio (VBR) was determined; even variations as small as 1 mm can result in a 10% change in VBR. The amount of within-subject variability in VBR that could result from this factor alone appears to be more than twice as large as that encountered with direct volume measurements, indicating that the latter measure would be at least twice as sensitive to real changes in ventricular size as the VBR.
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Affiliation(s)
- B T Woods
- Dept. of Neurology, McLean Hospital, Belmont, MA 02178
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16
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Abstract
The authors review the evidence indicating that puerperal psychosis is a nosological entity. The psychosis most closely resembling puerperal psychosis is the schizophreniform variant of manic-depression, and the authors propose that if marked differences can be found between that state and puerperal psychosis, then the finding will tend to confirm the separateness of puerperal psychosis. They compare two such sets of patients, and conclude that the claim of puerperal psychosis to the status of a nosological entity is further supported.
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17
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Smart M, Douglass A, Bland R. Psychiatry in the prelicensure internship. The position of the Canadian Psychiatric Association. Can J Psychiatry 1982; 27:597-600. [PMID: 7172161 DOI: 10.1177/070674378202700715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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